老年患者(≥60岁)初次经皮冠状动脉介入治疗的住院临床结果

IF 0.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL International journal of clinical and experimental medicine Pub Date : 2015-07-15 eCollection Date: 2015-01-01
Ya-Min Su, Xing-Xing Cai, Hai-Hua Geng, Hong-Zhuan Sheng, Meng-Kan Fan, Min Pan
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引用次数: 0

摘要

老年患者st段抬高型心肌梗死(STEMI)的死亡风险较高。然而,尽管最近设备和技术都取得了进展,但该亚组接受原发性经皮冠状动脉介入治疗(PPCI)的临床结果尚未得到很好的确定。在目前来自中国单中心的回顾性队列研究中,我们评估了接受PPCI的老年患者(≥60岁)的临床结局和死亡率预测因素。主要终点为即时血管造影成功和院内手术成功。次要终点为院内全因死亡。2011年1月至2013年12月,共有184例急性STEMI患者连续接受PPCI。老年组116例(63.04%)。尽管两组间病变复杂程度不同,但即刻血管造影成功率相似(老年组93.97%,非老年组94.12%,P=0.966)。两组手术成功率差异无统计学意义(老年组90.52%,非老年组94.12%,P=0.389)。老年组住院死亡率高于非老年组(8.62% Vs 1.47%, P=0.048)。死亡的主要原因是心源性休克和恶性心律失常(室性心动过速和纤颤)。我们的结果表明,老年人PPCI是可行的,并且有很高的可能性立即血管造影和手术成功。
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In-hospital clinical outcomes of elderly patients (≥60 years) undergoing primary percutaneous coronary intervention.

Elderly patients are at high risk of mortality when they present with ST-elevation myocardial infarction (STEMI). However, the clinical outcomes of this sub-group undergoing primary percutaneous coronary intervention (PPCI) have not been well established, despite recent advances in both devices and techniques. In the present retrospective cohort study from a Chinese single center, we assessed the clinical outcomes and predictors of mortality in elderly patients (≥60 years) underwent with PPCI. The primary endpoints were immediate angiographic success and in-hospital procedural success. The secondary endpoints were all-cause death in hospital. Between January 2011 and December 2013, a total of 184 consecutive patients with acute STEMI underwent PPCI were enrolled. 116 (63.04%) patients were in the elderly group. Despite the difference in lesion complexity between groups, the immediate angiographic success rate was similar (93.97% in the elderly group, and 94.12% in the non-elderly group, P=0.966). The procedural success rate were not significantly different between the two groups (90.52% in the elderly group, and 94.12% in the non-elderly group, P=0.389). However, in-hospital mortality was statistically higher in elderly group than in the non-elderly group (8.62% Vs 1.47%, P=0.048). The major causes of death were cardiac shock and malignant arrhythmias (ventricular tachycardia and fibrillation). Our results indicate that PPCI in the elderly is feasible and has a high likelihood of immediate angiographic and procedural success.

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